Oscar | Simple Silver

Simple Silver is an Obamacare health insurance plan offered by Oscar that is available for individuals and families.

This plan is a EPO, meaning you will have some of the flexibility to manage more of your health care without a primary care physician, however, you will need to stay within the provider’s network. (Read more about EPOs.)

This plan is a Silver metal level plan, which generally has a mid-level monthly cost and deductible (and co-pay), and provides middle-of-the-road insurance coverage for people who occasionally use their health care benefits (doctors, prescription drugs, etc.).

Deductible amount of $5,900. A deductible is the amount of healthcare costs you will pay on your own each year before the insurance company.

Max out-of-pocket of $5,900, which is the most you will pay in a plan year outside of premiums, out-of-network providers and non-essential health benefits.

Plan Summary

Who is this plan for?

This plan with a moderate monthly cost is great for individuals and families who occasionally visit the doctor or use prescription drugs. The very high deductible on this plan means you will pay a significant amount of money of pocket for medical care and prescriptions before your insurance kicks in. The very high out-of-pocket maximum on this plan means you could be faced with a very expensive medical bill if an emergency happens.

HealthCare.com is a privately-held internet start-up for healthcare consumers. We’re not the government website.

Highlights

Dental Coverage:

Child

Emergency Room:

No Charge after deductible

Generic Drugs:

No Charge

Overview

Plan Type:

EPO

Metal Level:

Silver

Health Spending Account:

No

Primary Care Office Visit:

No Charge

Specialist Office Visit:

No Charge after deductible

Out of Network Coverage:

No

Out of Country Coverage:

No

Coverage Details

Preventive Care

Periodic Health Exam

In Network:

No Charge

Out of Network:

Not Covered

Well Baby Care

In Network:

No Charge

Out of Network:

Not Covered

Inpatient

Hospital Services

In Network:

No Charge after deductible

Out of Network:

Not Covered

Outpatient

Surgery

In Network:

No Charge after deductible

Out of Network:

Not Covered

X-ray and Diagnostics

In Network:

No Charge after deductible

Out of Network:

Not Covered

Labs

In Network:

No Charge after deductible

Out of Network:

Not Covered

Facility Fee

In Network:

No Charge after deductible

Out of Network:

Not Covered

Additional Coverage

Chiropractic Care

In Network:

No Charge after deductible

Out of Network:

Not Covered

Doctor Visits

Primary Care Visit

In Network:

No Charge

Out of Network:

Not Covered

Specialist Visit

In Network:

No Charge after deductible

Out of Network:

Not Covered

Other Practitioner Office Visit

In Network:

No Charge

Out of Network:

Not Covered

Preventative Care / Screening / Immunization

In Network:

No Charge

Out of Network:

Not Covered

Emergency Room and Urgent Care

Emergency Room Services

In Network:

No Charge after deductible

Out of Network:

No Charge after deductible

Urgent Care Services

In Network:

No Charge after deductible

Out of Network:

No Charge after deductible

Ambulance/Transportation Services

In Network:

No Charge after deductible

Out of Network:

No Charge after deductible

Drugs

Generic Prescription

In Network:

No Charge

Out of Network:

Not Covered

Retail Brand Drugs

In Network:

Not Covered

Out of Network:

Not Covered

Non Retail Brand Drugs

In Network:

No Charge after deductible

Out of Network:

Not Covered

Specialty Drugs

In Network:

No Charge after deductible

Out of Network:

Not Covered

Additional Plan Information

HealthCare.com is a privately owned website, and monthly costs shown above are estimates only.
Your monthly premium may change based on the data provided, outside fees, optional benefits
or if other factors take effect before your coverage start date. Note that insurance companies
reserve the right to change your premium rate and the policy terms at any time. Effective date,
benefit amounts and other conditions may apply at the discretion of the insurance carrier you select.
Depending on your state of residence, this website may not display all plans available by state.
The Obamacare Tax Subsidy Calculator amounts are estimates only and the actual amount of subsidy
eligibility may differ. Access to your physician depends on network selected, and networks can
change without notice. Contact your health insurance company to confirm your healthcare provider
is still available in the network you select.